This project is funded by the MPS foundation
Background:
Menopause is a transition experienced by all women and is considered a taboo subject in many workplaces. It is estimated that by 2030 there will be 1.2 million menopausal and post-menopausal women globally. Given the average age of menopause is 51 and, in 2021, 47% of women aged 45-59 were employed, many women experience symptoms of the menopause whilst working. Multiple organisations worldwide have highlighted the importance of considering the menopause and adapting working environments, to support women to stay in work.
The implication for the healthcare workforce is clear. Three quarters of the UKâs National Health Service (NHS) workforce is female and 19% of the total NHS workforce was of menopausal age in 2019. Interventions including policies, guidelines, menopause cafes and clinics are being set up to support women experiencing menopause at work. There is limited evidence of the effectiveness of these interventions. Developing a greater understanding of what works, why and for whom, can support women to get the support they need.
Summary of the project:
We will first identify interventions for NHS staff that aim to minimize the impact of menopause on the healthcare workforce, including those not yet published in the peer-reviewed literature. Once identified, the interventions will then be mapped to existing typologies and frameworks to determine their targets and mechanisms of action.
The next phase will be to undertake a realist evaluation with the aim to work with and learn from three purposively selected NHS Trusts to analyse the interventions being offered to support healthcare professionals experiencing menopause.
Outcomes:
This research will provide a better understanding of the interventions for menopause support at work. Understanding which interventions work (or not) for who in what settings as well as understanding why they work will help healthcare professionals experiencing menopause at work be better supported in the future. This improved support is likely to benefit the women themselves, as well as the organisation as it will not be losing its experienced staff.
This project is investigating the impact of shared social spaces on wellness and learning of junior doctors. It is led by Dr Ciska Uys, an Anaesthetic registrar undertaking an Academic Clinical Fellowship in Medical Education supervised by Professor Karen Mattick and Dr Daniele Carrieri.
A significant finding from Care Under Pressure (CUP)1 was that connectedness between colleagues and sense of belonging appear to be one of the most important factors to prevent and reduce mental ill-health. Shared social spaces in which healthcare staff can meet informally are thought to improve connectedness, however these spaces are in decline. Nearly 20% of junior doctors in the UK do not have access to a âcommon roomâ, according to 2019 data from the British Medical Association.
We have recently published the findings of our scoping review, which identified several ways in which shared social spaces may impact positively, not only on wellness, but also on learning of junior doctors. Four significant common attributes of shared social spaces can be credited with positive impacts on wellness and learning. 1) Informal; fostering connectedness and belonging, trust and teamwork and offering access to informal help and support. 2) Safe; allowing reflection, debrief and raising of concerns. 3) Functional; there is planning of clinical care activity, sense of control and engagement from users and provision of refreshment. 4) Legitimate; regular maintenance and use of shared social spaces affect role modelling, sustainability and wellness culture. However, we found that although the value of spaces such as the coffee room and doctorsâ mess is widely talked about, there is currently very little empirical data to inform our understanding.
Therefore we will collect data in one UK hospital, which will involve mapping of shared social spaces, observation and realist interviews, to allow us to further our understanding of what happens in shared social spaces and how and why this impacts wellness and learning. The findings of this research will provide doctors, other stakeholders and policy makers with evidence of how shared social spaces are used; when, why and for whom they are significant; and what we need to do to create or preserve spaces that are effective in supporting learning and wellness.
Key publication:
Uys C, Carrieri D, Mattick K. Theimpact of shared social spaces on the wellness and learning ofjunior doctors: A scoping review.Med Educ. 2023;57(4):315â330. doi:10.1111/medu.14946330
Further information:
After a successful pilot, NHS Devon has committed to continue funding an innovative programme to support GPs, aimed identifying and supporting doctors under stress before their health or performance suffers.
Thanks to this support, GPs will be able to access to a range of new support services, including wellbeing focused coaching, peer support groups and mindfulness training. Of course, you will still be able to access all the existing services (such as the Practitioner Health Programme and support from the LMC).
In addition, under this new initiative GP appraisers are being encouraged to explore wellbeing with their appraisees, and are being provided with the guidance and resources to do this in a sensitive and supportive way. Please use your appraisal as an opportunity to reflect upon and prioritise your own wellbeing.
We are all increasingly concerned about the wellbeing of our GP colleagues. We know what fantastic work you all do, and the pressure youâre under. Itâs completely understandable to feel stressed at this difficult time for the NHS, and itâs ok not to be ok. All we ask is that if youâre not ok, please do something about it: talk to colleagues, seek out the support you need. Help is available. If youâre having a difficult time, we believe that accessing support can make all the difference.
If you would like to know more about this programme, please email vik.mohan@nhs.net
This project explores the experience of âthe class of COVIDâ new medical graduates who are starting work in the UK during the COVID-19 crisis. It is led by Newcastle University School of Medical Education, with colleagues from Exeter University, Plymouth University and Queenâs University Belfast. It is supported by the GMC, Medical Schools Council and other stakeholders, and will explore with questionnaires and interviews how starting practice at this unprecedented time affects new doctors. This is the only study with the support of all national bodies responsible for trainee doctors.
For further information see: https://blogs.ncl.ac.uk/2020medicalgraduates/
Burford B, Vance G, Goulding A, Mattick K, Carrieri D, Gale T, Brennan N. (2021). 2020 Medical Graduates: The work and wellbeing of interim Foundation Year 1 (FiY1) doctorsâ during COVID-19. GMC report.
Mattick K, Goulding A, Carrieri D, Brennan N, Burford B, Vance G, Dornan T (2023). Constraints and affordances for UK doctors-in-training to exercise agency: a dialogical analysis. Medical Education.
Burford B, Mattick K, Carrieri D, Goulding A, Gale T, Brennan N, Vance G. How is transition to medical practice shaped by a novel transitional role? A mixed-methods study. BMJ open. 2023 Aug 1;13(8):e074387. https://bmjopen.bmj.com/content/13/8/e074387.info
Excellent Medical Education Joint Association for the Study of Medical Education/General Medical Council Awards 2019 CPD category
This project aims to develop evidence-based recommendations to optimise current strategies to address mental ill-health and to promote wellbeing for medical students at the College of Medicine and Health (CMH), University of Exeter.
The mental health of medical students and doctors is a pressing concern in the UK and worldwide. Its consequences are far reaching and include dropout, depression, self-harm, suicide, poor academic performance and patient care. This complex problem requires multi-level integrated approaches targeting individual âskillsâ, as well as changes at organisational, professional and cultural levels.
In the UK, regulatory bodies and institutions such as the GMC and HEE have argued for the importance to start early in developing doctorsâ wellbeing, self-awareness, and self-care. A growing number of medical schools in the UK are introducing a wide variety of different initiatives to promote wellbeing and tackle mental ill-heath. However, most programme leaders and educators lack guidance and resources to develop these initiatives or to properly incorporate them within education and training programmes.
This project aims to address this gap by undertaking a realist evaluation of the delivery and impacts of the initiatives to support the health and wellbeing of the medical students at the University of Exeter. The main objectives are to: make explicit the implicit theories held by educators who have been involved in the design and delivery of wellbeing curriculum and initiatives to understand their beliefs about the different contexts, mechanisms and outcomes that may be important to promote wellbeing; develop an explanatory account of whether/how these initiatives are working, for whom, under what circumstances and why (not); develop an evidence-based plan to optimise strategies to support medical studentsâ wellbeing.
This study will be undertaken at the University of Exeter, but some of the findings and the methodology employed may be relevant and transferable to other medical schools.
